The BackTable Podcast is a resource for interventional radiologists, vascular surgeons, interventional cardiologists, and other interventional and endovascular specialists to learn tips, techniques, and the ins and outs of the devices in their cabinets. Listen on BackTable.com or on the streaming platform of your choice. You can also visit www.BackTable.com to browse our open access, physician-catered knowledge center for all things vascular and interventional; now featuring practice tools, procedure walkthroughs, and expert guidance on more than 40 endovascular procedures.
Ep. 668 Entrepreneurship in Medicine: Bridging Healthcare and Business with Dr. Nneka Una
Are you building a business that can thrive without you, or just creating a job you can never leave? In this episode of BackTable Women’s Health, host Dr. Karen Toubi sits down with Dr. Nneka Una (Unachukwu), a board-certified pediatrician, founder of Ivy League Pediatrics, and creator of EntreMD, to discuss the mindset and skills needed to build a truly sustainable medical practice. The conversation explores why physician entrepreneurship is essential in today’s evolving healthcare landscape, the difference between building yourself a job and building a resilient business, and practical strategies for long-term growth. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps00:00 - Introduction04:47 - From Employee to Owner05:53 - Skills That Changed Everything07:35 - The Wake Up Call10:44 - Why Doctors Resist Business15:06 - Profit as Patient Care18:20 - Job vs. Business Entity21:13 - CEO Hat and Team Systems25:14 - Exit Value and Sellability29:00 - More Profit: More Time Off30:24 - Fear Before Breakthrough35:32 - Choose Service Over Perfection39:11 - Invest in Your Potential46:26 - MEAT Week Priorities48:40 - Three-Part Daily Rhythm55:02 - Advice for Burned-Out Docs59:29 - Wrap Up --- More about this episodeDr. Una shares how doctors can overcome resistance to “business,” why every practice needs a strong business engine, and how to balance profitability with ethical, people-centered care. She explains how to shift from employee to physician-CEO, tackle imposter syndrome, and develop systems that give your practice true staying power. The discussion provides actionable advice on hiring, team management, building exit value, and creating the freedom to take more time off without sacrificing patient care or financial stability. --- ResourcesEntreMD https://entremd.com/about-us/ The Profitable Private Practice Playbook https://entremd.com/method-book/ --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty.► https://www.backtable.com/app
Ep. 667 Aortoiliac Arterial Disease Treatment with Dr. Eric Secemsky
How do you decide between a dedicated aortic scaffold and kissing stents in complex aortoiliac bifurcations? On this episode of the BackTable Podcast, Dr. Sabeen Dhand and Dr. Eric Secemsky discuss the management of a female smoker presenting with rapidly progressive bilateral hip pain, ultimately revealed to be severe aortoiliac arterial disease. The case highlights the value of noninvasive vascular studies, CTA, and IVUS for precise diagnosis and procedural planning, as well as the nuanced decision-making process between different device options. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction01:56 - Patient History05:42 - CTA and Angio Findings09:30 - Strategy Access and IVUS13:17 - IVUS Sizing and Lesion Review16:38 - IVL Angioplasty Technique18:28 - Stenting and Final Result22:50 - Post-procedure Meds and Outcome24:34 - Wrap Up --- More about this episode Dr. Secemsky reviews access strategy, lesion sizing, and the use of intravascular lithotripsy to reduce rupture risk in heavily calcified arteries. The doctors explain their rationale for choosing kissing covered stents over a dedicated aortic scaffold, details the technical steps of ballooning and stenting, and discusses the transition from dual antiplatelet therapy to rivaroxaban and aspirin postprocedure. The episode concludes with key insights into device selection, procedural technique, and patient-centered decision-making for successful aortoiliac interventions. --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
Ep. 666 Dear IR Residency - Residency Reflection with Dr. Gregg Khodorov and Dr. Aesha Patel
What do new interventional radiologists wish they had known before starting residency? On this reflective episode of BackTable, Dr. Neil Jain is joined by chief residents Dr. Aesha Patel and Dr. Gregg Khodorov as they look back on six years of IR/DR training. They share what they wish they’d known as applicants, from the growing emotional weight of complications near graduation to the essential role of co-residents, support networks, and the evolving balance between confidence and competence. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction04:34 - Rapid Fire Reflections07:20 - Complications and Confidence12:01 - Applicant Misconceptions16:54 - Defining a Great Program26:38 - Lessons Learned Over Time29:12 - Pearls and Hard-Won Lessons33:09 - Valuing Bread-and-Butter Cases35:24 - Complications and Empathy41:03 - Memorable Attending Phrases 43:06 - Habits for the Future47:34 - Mentorship and Craftsmanship52:42 - IR Culture and Professional Pride57:44 - The Future of IR Training01:08:34 - Closing Thoughts --- More about this episode They discuss how their definition of a “good case” has evolved, the importance of mastering bread-and-butter procedures, and the impact of habits like detailed note-taking, patient-centered communication, and taking ownership of complications. The episode highlights ideas for future training improvements and offers advice on valuing patient interactions, embracing growth, and developing sound clinical judgment under pressure. Throughout, the conversation underscores the personal and professional growth that comes from these challenges and the lasting value of camaraderie and mentorship in interventional radiology. --- Resources Perspective on the New IR Residency Selection Process: 4-year Experience at a Large, Collaborative Training Programhttps://www.sciencedirect.com/science/article/pii/S1076633221000568 Diversity in Interventional Radiology Residency Programshttps://www.sciencedirect.com/science/article/abs/pii/S1546144025002765 Implementation and Evaluation of a Comprehensive Simulation Curriculum for the IR/DR Integrated Residencyhttps://www.sciencedirect.com/science/article/abs/pii/S107663322300051X --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
Ep. 665 Advanced Strategies for Targeted Bone Biopsies with Dr. Peter C. Thurlow
A bone biopsy can reach the target and still miss the diagnosis. In this episode of the BackTable Podcast, host Dr. Neil Jain is joined by Dr. Peter Thurlow to discuss how lesion selection, imaging review, trajectory planning, and device choice determine whether a targeted bone biopsy produces a useful sample without compromising future treatment. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported byVarian https://cancercare.siemens-healthineers.com/products/interventional-oncology/musculoskeletal/omnibone --- Timestamps 00:00 - Introduction04:17 - Approaching Focal Bone Lesions06:17 - Differentiating Lesions and Pain Management13:13 - Settling on Bone Biopsy Imaging16:55 - Understanding Pre-Op Imaging from Lesion Characteristics 21:50 - Maintaining Communication Across Specialties24:21 - Which Devices To Select and Navigating Challenges32:28 - Trajectory Paths and Surgical Considerations35:30 - How to Avoid and Mitigate Biopsy Complications41:30 - Wrap Up --- More about this episode The conversation begins with a systematic approach to evaluating focal bone lesions, including the likelihood of malignancy, lesion location, number of lesions, and selection of an appropriately sized sampling device. Dr. Thurlow reviews anesthesia and pain-management strategies for both superficial and deeper osseous targets, as well as the respective roles of MRI and CT in procedural planning. For challenging lesions, he explains why needle-guidance technology may be preferable to adjusting gantry tilt and outlines how imaging findings and biopsy strategy should be tailored to lesion type, with particular attention to the difficulties associated with blastic lesions. The doctors also discuss the importance of communication with pathology, surgery, oncology, and other collaborating specialties before proceeding. Dr. Thurlow shares his preferred biopsy devices, considerations for selecting a safe trajectory, and ways to account for potential future surgical approaches. The episode concludes with practical strategies for avoiding complications, minimizing tissue injury, and obtaining an adequate diagnostic sample. --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
Ep. 664 Understanding Genicular Artery Embolization for Knee Osteoarthritis with Dr. Peter Minko
Genicular artery embolization (GAE) continues to gain traction worldwide, but is the evidence catching up to the hype? In this episode of BackTable Bone and Sports Podcast, host Dr. Kavi Krishnasamy welcomes Dr. Peter Minko, an interventional radiologist from Düsseldorf, Germany, to discuss GAE’s evolving evidence, techniques, and international practice patterns. Dr. Minko highlights forthcoming clinical trials and emphasizes the need for high-quality research to guide patient care. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps00:00 - Introduction03:13 - The Embolization Landscape in Germany07:25 - The Basics of GAE Patient Workup 13:49 - The Unideal Patient Candidate for GAE16:55 - Measuring Outcomes Beyond Clinical Scores23:14 - Procedure Specifics: Minko’s Choice36:28 - Discussing the Future of Temporary vs. Permanent Embolics43:47 - Collateral Flow Strategy and Procedure Wrap-Up49:05 - Post-Procedure Rehab Guidelines52:00 - Repeat GAE Treatment Algorithm 58:00 - Safety and Outcomes in Post-TKA Patients01:04:11 - GAE and Associations with the Hospital Anxiety and Depression Scale (HADS)01:09:40 - Call for Better Trials and Evidence in GAE01:14:11 - Case Presentation: GAE Transpedal Access Case01:21:05 - Case Presentation: “Three Stop Shop” Anastomosis 01:27:08 - Case Presentation: AV Fistula… Due to Arthroscopy?01:32:03 - Case Presentation: Popliteal Agenesis 01:38:14 - Dr. Minko’s Perspective on the Future of MSK Embolization01:40:55 - Wrap Up --- More about this episodeThe doctors break down procedural specifics, including embolic materials, access site and catheter choices, and strategies for patient selection and contraindications. They discuss post-procedure rehabilitation, approaches to repeat GAE, and unique considerations for patients with prior total knee arthroplasty. The discussion also features interesting case presentations, explores the future of temporary versus permanent embolics, and examines the importance of robust study design in advancing MSK embolization. Dr. Minko shares his perspective on the direction of the field and the collaborative effort needed to move GAE evidence and practice forward. --- ResourcesDr. Peter Minkohttps://www.researchgate.net/profile/Peter-Minko --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty.► https://www.backtable.com/app
Ep. 663 Advancements in Tibial Artery Stenting & Scaffolding with Dr. Sahil Parikh
What is the emerging role of bioresorbable scaffolds in treating tibial artery disease, and how do they compare with traditional stenting and drug delivery approaches? In this episode of the BackTable Podcast, Dr. Sabeen Dhand interviews interventional cardiologist Dr. Sahil Parikh at Columbia to explore the evolution of tibial artery stenting, drug-eluting technology, and the latest evidence behind bioresorbable scaffolds. The discussion highlights patient selection, treatment algorithms, technical considerations, and the impact of drug delivery choices on patient outcomes. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by Abbott Cardiovascular https://www.cardiovascular.abbott/us/en/hcp/products/peripheral-intervention/esprit-btk-resorbable-scaffold-system.html --- Timestamps 00:00 - Introduction04:00 - Bioengineering Origins08:29 - Paclitaxel vs. Limus 13:43 - When to Stent Tibials 16:14 - Stepwise Tibial Algorithm 18:46 - Stent Platforms and Costs 23:09 - Bifurcation Stenting Basics 26:35 - Fracture and Crush Risks 30:10 - Device Selection: Born for Tibials 33:27 - Materials and Drug Kinetics 36:57 - How to Deploy Safely 40:46 - Cost and Reimbursement Reality 43:21 - Market Growth and Competitors 48:02 - Paclitaxel Mortality Scare 51:13 - Final Takeaways and Access --- More about this episode Dr. Parikh reviews the differences between paclitaxel and sirolimus or limus agents, the historical dominance of paclitaxel in peripheral devices, and why peripheral therapy has lagged behind coronary interventions. He outlines a practical tibial treatment algorithm emphasizing crossing (often with retrograde access), imaging to assess calcium, lesion preparation (including IVL, specialty balloons, and atherectomy when needed), proper sizing, and bailout stenting for recoil or dissection, and addresses the unique challenges of distal placement, bifurcations, and occasional fractures. The discussion covers the evolution and rationale, absorption timeline, and clinical data for bioresorbable scaffolds, as well as reimbursement, emerging alternatives, and the ongoing debate over paclitaxel safety. Dr. Parikh also shares his perspective on the future of drug delivery, the need for payer support, and strategies for ensuring the best patient care across diverse clinical settings. --- Resources US Esprit™ BTK System Product Information (https://www.cardiovascular.abbott/us/en/hcp/products/peripheral-intervention/esprit-btk-resorbable-scaffold-system.html?utm_medium=podcast&utm_source=backtable&utm_campaign=us-endo-esprit-btk&utm_division=vas&utm_product=esprit-btk&utm_content=kol&utm_type=other) US Esprit™ BTK System Important Safety Information (https://www.cardiovascular.abbott/us/en/hcp/products/peripheral-intervention/esprit-btk-resorbable-scaffold-system/important-safety-information.html) Drug-Eluting Resorbable Scaffold versus Angioplasty for Infrapopliteal Artery Disease(https://pubmed.ncbi.nlm.nih.gov/37888915/) --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
Ep. 662 Pathways to Interventional Radiology: ESIR vs. Integrated Dr. John Cieslak
With multiple training pathways, how can you determine which is the right choice for your career and clinical goals? In this episode of BackTable Podcast, Dr. Neil Jain sits down with interventional radiologist Dr. John Cieslak to compare the Early Specialization in Interventional Radiology (ESIR), integrated IR/DR, and independent IR routes. The conversation highlights practical differences in training structures, procedural exposure, and the key factors that influence career decisions for aspiring IRs. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction01:47 - Early Life and Science Roots 03:58 - Surgery to IR Pivot 05:51 - Radiology Training and ESIR Setup 08:59 - Three IR Training Pathways 11:53 - ESIR Pros Cons and Case Exposure 14:27 - Competency and Hiring Perceptions 20:12 - Job Market Academic vs Hospital 23:08 - Early Attending Surprises 26:00 - Integrated Versus ESIR 29:10 - Boosting Your Application 31:24 - Rapid Fire IR Questions 34:46 - Future Of IR 36:46 - Wrap Up And Credits --- More about this episode Dr. Cieslak shares his own journey, from early exposure to hospital science and a long academic path to switching from surgery to radiology and ultimately landing in IR. They outline the practical pros and cons of each pathway, including the flexibility and breadth of ESIR, the directness of integrated training, and the realities of re-matching and job market considerations. The discussion covers early attending challenges like building referrals and making independent decisions, the importance of multidisciplinary teamwork, and advice for residents and students interested in IR. The Drs. also discuss the evolution of IR procedures, the impact of program variability, and why persistence and exposure are vital for success in the field. --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
Ep. 661 Practical Strategies for Advanced Embolization Techniques with Dr. Harris Chengazi
As endovascular technologies evolve, how are IRs maximizing control while minimizing metal in modern venous embolization? In this episode of the BackTable Podcast, Dr. Harris Chengazi joins host Dr. Sabeen Dhand to discuss the clinical impact, deployment techniques, and imaging advantages of modern vascular point embolization devices, focusing on targeted venous occlusion and variceal obliteration. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by Okami Medicalhttps://okamimedical.com/ --- Timestamps 00:00 - Introduction02:22 - Multidisciplinary Vascular Practice Model05:51 - Understanding Plugs in Embolization08:34 - Comparing Plugs, Coils, and Liquid Embolics13:48 - LOBO Occlusive Device16:12 - Plug Sizing and Vessel Measurement20:45 - Deliverability and Catheter Selection24:28 - Limitations of Point Embolization29:03 - PARTO Access and Technique32:46 - Other LOBO Use Cases34:33 - LOBO Deployment Mechanism36:23 - Cost Effectiveness of Embolics41:08 - Final Thoughts and Closing Remarks --- More about this episode Dr. Chengazi shares insights from incorporating vascular plugs into his embolization practice after training predominantly with coils. He highlights the features that distinguish modern devices like the LOBO from traditional plugs, including their unique nitinol weave, rapid occlusion, and predictable sizing and landing configuration. The physicians explore the utility and limitations of plugs in clinical scenarios including retrograde transvenous variceal obliteration, antegrade variceal embolization during TIPS creation, and tract embolization following percutaneous procedures. Dr. Chengazi furthermore shares specific procedural pearls for point embolization of varices, explaining how to facilitate deployment using a parallel access technique as well as how to position multi-lobed plugs across venous outflow segments to reliably treat large shunts with a single device. Finally, the physicians review the benefits of reduced imaging artifact on follow-up scans compared to traditional coil packs and liquid embolics as well as the impact of modern plug technology on healthcare costs, reinforcing the value of evidence-based device selection for optimal patient outcomes. --- Resources Kundaragi NG, et al. Measurement of Inferior Vena Cava to Shunt Distance in Deciding Access Route for Balloon-Occluded Retrograde Transvenous Obliteration Procedure: A Pilot Study. Am J Interv Radiol. 2018 Sep 19;2(16):1-9.https://dx.doi.org/10.25259/AJIR-22-2018 --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
Ep. 660 Techniques & Outcomes of Portal Vein Embolization with Dr. David C. Madoff
How is portal vein embolization (PVE) pushing the boundaries of liver tumor resectability, and what does it take to induce hypertrophy without compromising the remnant liver? In this episode of the BackTable Podcast, interventional radiologist Dr. David Madoff of Yale University joins Dr. Michael Barraza to discuss the pathophysiological rationale, technical considerations, and emerging clinical paradigms of performing PVE to augment the future liver remnant (FLR) prior to resection and reduce the risk of postoperative liver failure. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by RADPAD® Radiation Protectionhttps://www.radpad.com/ --- Timestamps 00:00 - Introduction02:14 - IO Practice and Research07:25 - PVE Indications and Adequate FLR12:55 - Referrals and Patient Selection17:27 - PVE vs. Y90 Radiation Lobectomy22:12 - Liver Venous Deprivation25:31 - Measuring FLR Function30:11 - Procedural Planning and Technique36:36 - Preferred Embolic Agents and Challenges46:58 - Ipsilateral vs. Contralateral Access50:52 - Complications, Medications, and Follow-Up55:45 - Final Thoughts and Closing Remarks --- More about this episode The physicians dissect the anatomic and oncologic benchmarks used to select PVE candidates, including FLR volumetric thresholds for normal, steatotic, and cirrhotic livers. Dr. Madoff walks through his procedural technique, detailing catheter maneuvers and embolic administration, emphasizing the importance of evaluating for anatomic variants, and explaining the benefits of using an ipsilateral approach to protect the FLR. The doctors critique ongoing debates in hepatic augmentation, assess the complementary relationship between PVE and Y90 radioembolization, and discuss the outcomes and risks associated with different embolic agents. They stress the importance of patient selection and assessment protocols that go beyond static volumetric measurements to incorporate functional parameters for better prediction of regenerative kinetics and clinical outcomes. The episode concludes with a review of postprocedural follow-up and potential complications, highlighting the importance of considering pathophysiologic dynamics of both the tumor and the anticipated liver remnant to ensure successful treatment. --- Resources DRAGON Trialhttps://www.dragontrial.com/ Three hundred and one consecutive extended right hepatectomies: Evaluation of outcome based on systematic liver volumetryhttps://doi.org/10.1097/SLA.0b013e3181b674df Portal vein embolization with N-butyl-cyanoacrylate improves liver hypertrophy compared to microparticles – A Swedish multicenter cohort studyhttps://doi.org/10.1016/j.heliyon.2023.e21210 --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
Ep. 659 Combination Therapy for Hepatocellular Carcinoma with Dr. Beau Toskich and Dr. Lingling Du
How do you safely combine locoregional and systemic therapies to treat hepatocellular carcinoma (HCC) when traditional guidelines suggest your hands are tied? In this episode of the 2026 HCC Creator Weekend™, medical oncologist Dr. Lingling Du (Ochsner Health) and interventional radiologist Dr. Beau Toskich (Mayo Clinic Florida) join Dr. Tyler Sandow to break down patient selection, timing strategies, and the practical application of clinical trial outcomes when integrating Y90 radioembolization and immunotherapy in HCC management. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by an educational grant from Sirtex and Boston Scientific. --- Timestamps 00:00 - Introduction01:48 - Two HCC Cases03:31 - Disease Progression on Combination Therapy07:05 - Alternatives After Immunotherapy Failure09:09 - Salvage with Ablative Y9013:41 - Mechanism of Immunotherapy15:43 - EMERALD-1 and LEAP-01220:52 - Adverse Events with Combination Therapy27:21 - Treatment Timing and Sequencing28:48 - Case: Borderline BCLC B33:48 - Case: BCLC C with Portal Vein Thrombus37:06 - Raising the Survival Tail40:11 - Final Thoughts and Closing Remarks --- More about this episode The physicians highlight how selective local treatment can achieve complete responses and salvage cases with aggressive disease. They emphasize that treatment based on anatomical and biological phenotype may yield better results than strictly adhering to rigid staging categories, while acknowledging the challenges of managing microscopic disease and unpredictable long-term tumor behavior. Dr. Du and Dr. Toskich also note that selecting the right combination regimens requires balancing aggressive tumor kinetics against the patient’s baseline liver function, pointing out that well-tolerated regimens like STRIDE are often easier to pair with Y90 than checkpoint or VEGFR inhibitors that alter tumor blood flow. While recent TACE-immunotherapy trials (EMERALD-1 and LEAP-012) may be confounded by patient heterogeneity, the physicians observe that a distinct subset of patients achieves durable, long-term remission, effectively raising the survival tail for an otherwise incurable population. Ultimately, they conclude that cross-specialty education and leaning into the expert intuition of a multidisciplinary team are essential for securing the best outcomes for patients with intermediate and advanced HCC. --- Resources Study of Durvalumab and Tremelimumab as First-line Treatment in Patients With Advanced Hepatocellular Carcinoma (HIMALAYA)https://clinicaltrials.gov/study/NCT03298451 A Study of Atezolizumab in Combination With Bevacizumab Compared With Sorafenib in Patients With Untreated Locally Advanced or Metastatic Hepatocellular Carcinoma (IMbrave150)https://clinicaltrials.gov/study/NCT03434379 Nivolumab plus ipilimumab versus lenvatinib or sorafenib as first-line treatment for unresectable hepatocellular carcinoma (CheckMate 9DW): an open-label, randomised, phase 3 trialhttps://doi.org/10.1016/S0140-6736(25)00403-9 Durvalumab with or without bevacizumab with transarterial chemoembolisation in hepatocellular carcinoma (EMERALD-1): a multiregional, randomised, double-blind, placebo-controlled, phase 3 studyhttps://doi.org/10.1016/S0140-6736(24)02551-0 Transarterial chemoembolisation combined with lenvatinib plus pembrolizumab versus dual placebo for unresectable, non-metastatic hepatocellular carcinoma (LEAP-012): a multicentre, randomised, double-blind, phase 3 studyhttps://doi.org/10.1016/S0140-6736(24)02575-3 --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
Ep. 658 Expeditionary Interventional Radiology: Innovations in Military Medicine with Dr. Jonathon Schutt and Dr. John Pavlus
How will expeditionary IR adapt and advance to meet the challenges of the next generation of combat operations? In this episode of the Backtable Podcast, host Dr. Ally Baheti speaks with Air Force IR physicians Dr. John Pavlus and Dr. Jonathon Schutt about the realities of expeditionary interventional radiology (EIR) in military and disaster settings. They discuss how EIR brings damage-control and emergency IR principles to deployments, humanitarian missions, and extreme environments, where resources are limited and teamwork is essential. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction03:53 - Origins and Early Pushback 06:31 - Roles of Care 09:04 - Trauma vs Elective12:09 - Staffing and Training Barriers 22:17 - Future Tech: AI and Robotics 29:24 - Why It Matters in War35:00 - Teamwork Trust and 60 Minutes39:20 - Military Culture41:18 - Wrap Up and Thanks --- More about this episode The conversation explores the military’s “roles of care,” from stateside hospitals to front-line deployments, and examines how limited IR staffing and siloed services present barriers to readiness. Drs. Pavlus and Schutt emphasize the importance of close integration with trauma surgery, anesthesia, and other team members, and highlight trauma-focused endovascular care and ultrasound-guided procedures that work with minimal equipment. The episode also looks at future directions for expeditionary IR, including new training models, data systems, and advances in AI and robotics that may one day enable remote intervention in combat and disaster zones. --- Resources Expeditionary Endovascular Trauma Care as a Core Capability for Future Large-Scale Conflictshttps://pubmed.ncbi.nlm.nih.gov/41894613/ --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
Ep. 657 Advanced Techniques in Y90 Cancer Treatment with Dr. Beau Toskich and Dr. Juan Gimenez
What do you do when Y-90 doesn’t deliver the results you expected? In this episode of the 2026 HCC Creator Weekend™, host Dr. Tyler Sandow is joined by Drs. Beau Toskich and Juan Gimenez to discuss the technical challenges and troubleshooting strategies that can make or break a Y-90 radioembolization case. Together, they explore innovative approaches like the PREDATr technique, share tips for reducing complications, and offer guidance on optimizing outcomes for patients with complex liver tumors. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by an educational grant from Sirtex and Boston Scientific. --- Timestamps 00:00 - Introduction04:24 - Treatment Nonresponse Troubleshooting06:12 - Navigating Y90 Through Replaced Arteries09:09 - Mitigating Vasospasm in Embolization13:31 - What is ‘PREDATr’?21:12 - Dual Balloon Microcatheter System23:37 - Gelfoam Techniques and Application26:06 - Embolization Agents Preferences36:16 - Concerns with Cystic Artery Treatment and Biliary Stents42:15 - Prophylactic Antibiotics 44:29 - Utilizing High Lung Shunts49:28 - Wrap Up and Credits --- More about this episode The conversation begins with case-based examples of HCC radioembolization, focusing on how to assess treatment response and troubleshoot nonresponsive cases. They discuss how to interpret SPECT findings, identify missed tumor supply with cone-beam CT, and overcome obstacles such as vasospasm, extrahepatic feeders, and challenging arterial anatomy. They introduce the PREDATr technique (proximal radioembolization enabled by distal angiozone truncation) and explain how tools like gelfoam, balloons, and retrievable coils can preserve healthy liver tissue and improve microsphere delivery. The episode also addresses managing biliary stents, using antibiotic prophylaxis, and strategies for handling high lung shunts, making it a practical resource for anyone navigating the complexities of Y-90 treatment. --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
Ep. 656 Advanced Practices in Uterine Fibroid Embolization with Dr. Francis Kang and Dr. Neil Resnick
Are new technologies and teamwork the key to better fibroid treatment? In this episode of the BackTable Podcast, Drs. Francis Kang and Neil Resnick join host Dr. Chris Beck to share how multidisciplinary treatment planning is reshaping uterine fibroid management, from patient selection and referral patterns to procedural techniques that improve outcomes. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported byTriSalus Life Scienceshttps://trinavinfusion.com/ --- Timestamps00:00 - Introduction06:18 - Multidisciplinary Care of Fibroids15:45 - Treatment Decisions21:56 - Managing Asymptomatic Fibroids25:43 - Collaborative vs. Competitive Practices30:01 - UFE Procedure Approaches34:32 - Comparing Embolic Sizes and Amounts37:44 - Changes in Speed Using TriNav Catheters40:53 - Tactile Feedback at Stasis42:28 - Embolization Target Regions44:45 - Encountering and Troubleshooting Collaterals47:30 - Post-Op Pain Regiments57:28 - Wrap Up --- More about this episodeThe conversation begins with the importance of strong partnerships with OBGYN colleagues and how multidisciplinary planning leads to better outcomes for patients. They explore patient selection and education, especially for those considering surgical versus minimally invasive treatment options. Drs. Kang and Resnick compare procedural approaches, including when to use femoral versus transradial access, nerve blocks, and embolic particle selection. They also discuss strategies to achieve optimal embolization endpoints and practical tips for handling collateral vessels, avoiding non-target embolization, and managing post-procedural pain and recovery. The episode concludes with a look at newer technologies like the TriNav Catheter and its impact on embolization speed, operator confidence, and early imaging outcomes.--- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty.► https://www.backtable.com/app
Ep. 655 Managing Large Liver Tumors: Strategies and Challenges with Dr. Beau Toskich, Dr. Chris Malone, and Dr. Tyler Sandow
How is Y90 radioembolization rewriting the rules for managing large HCC tumors and creating new curative-intent therapeutic pathways where palliation was once deemed the only option? In this episode of the 2026 HCC Creator Weekend™, interventional radiologists Dr. Chris Malone (WashU), Dr. Tyler Sandow (Ochsner Health), and Dr. Beau Toskich (Mayo Clinic Florida) join host Dr. Zach Berman for a case-based discussion on advanced dosimetric strategies and embolization approaches for large and complex HCC lesions. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by an educational grant from Boston Scientific. --- Timestamps 00:00 - Introduction01:59 - Case 1: Ablative Dosing to Solitary Tumor04:38 - Post-Treatment Residual Arterial Enhancement07:35 - Case 2: Tumor with Multiple Feeding Arteries10:02 - Role of Combination with Immunotherapy13:01 - Case 3: Large Caudate Tumor16:03 - Approach to Extrahepatic Arterial Supply19:14 - Case 4: Tumor Adjacent to Viscera21:32 - Does Microsphere Count Matter?24:10 - Case 5: Radioembolization in HCC Downstaging28:18 - Dosing Paradigms for Large Tumors33:06 - Case 6: Pressure-Augmented Delivery35:16 - Case 7: Multifocal Disease and Satellite Lesions37:47 - Palliative Dosimetry vs. Radiation Lobectomy40:11 - Significance of Complete Pathonecrosis43:25 - Closing Remarks --- More about this episodeThe physicians discuss systematic approaches to patient selection, the nuances of MIRD single-compartment versus multi-compartment dosing, and the critical role of precise mapping and particle dynamics in optimizing treatment for heterogeneous tumors. The panel also examines how to navigate the risks and situational challenges of delivering high radiation doses to large central and multifocal tumors. They address practical concerns such as responding to post-treatment imaging changes, managing long-term risks like biliary strictures, and ensuring the safety of treating disease near mobile viscera. The specialists highlight the power of Y90 in successful downstaging, citing evidence of its superior potential to achieve complete pathological necrosis (CPN) at explant when compared with other modalities. Ultimately, they advocate for a bold, collaborative approach within the multidisciplinary tumor board, encouraging providers to employ combination therapies and advanced technologies to optimize patient outcomes and expand the boundaries of curable HCC. --- Resources Yttrium-90 Radioembolization for the Treatment of Solitary, Unresectable HCC: The LEGACY Studyhttps://doi.org/10.1002/hep.31819 A US Study to Evaluate Transarterial Radioembolization (TARE) in Combination With Durvalumab and Bevacizumab Therapy in People With Unresectable Hepatocellular Carcinoma Amenable to TARE (EMERALD-Y90)https://clinicaltrials.gov/study/NCT06040099 TheraSphere With Durvalumab and Tremelimumab for HCC (ROWAN)https://clinicaltrials.gov/study/NCT05063565 Personalized versus standard dosimetry approach of selective internal radiation therapy in patients with locally advanced hepatocellular carcinoma (DOSISPHERE-01): a randomised, multicentre, open-label phase 2 trialhttps://doi.org/10.1016/S2468-1253(20)30290-9 Downstaging Outcomes for Hepatocellular Carcinoma: Results From the Multicenter Evaluation of Reduction in Tumor Size before Liver Transplantation (MERITS-LT) Consortiumhttps://doi.org/10.1053/j.gastro.2021.07.033 --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
Ep. 654 Advances in PE Treatment Guidelines with Dr. Jay Giri and Dr. Trevor Cummings
Will new PE guidelines redefine risk and therapy in pulmonary embolism (PE) care? In this episode of the BackTable podcast, host Dr. Michael Barraza is joined by interventional cardiologist Dr. Jay Giri and emergency physician Dr. Trevor Cummings to break down the latest changes in PE management. They discuss how multidisciplinary pulmonary embolism response teams (PERT) are implementing these guidelines at their institutions, the introduction of a more nuanced A-E risk stratification system, and the challenges of enrolling experienced centers into clinical trials as device innovation accelerates. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by Stryker Peripheral Vascular, formerly Inari Medicalhttps://www.inarimedical.com/flowtriever-system --- Timestamps 00:00 - Introduction 01:24 - Building a PERT Team04:59 - Trials Shaping PE Care 10:20 - Why New Guidelines Now 14:06 - New Risk Categories Explained 19:51 - Applying Guidelines Locally 23:34 - What Is C1 Risk 27:52 - New D Category Explained 30:33 - Evidence for Aggressive Therapy 33:31 - How PERT Teams Communicate 38:22 - Upcoming PE Trials Pipeline 43:42 - Program Growth and High Risk Trials 45:46 - Closing Remarks --- More about this episode The conversation highlights the growth of catheter-directed lysis and mechanical thrombectomy, the rationale and practical impact of the new Category D for incipient cardiopulmonary failure (including normotensive shock), and the incorporation of PESI, sPESI, and Hestia for risk assessment. Additional topics include decision-making for low-risk patients, lactate and biomarkers for identifying higher-risk cases, communication strategies within PERT teams, AI-enabled risk stratification, and a preview of upcoming trials (PEITHO, PRAGUE-26, PEERLESS-2, PE-TRACT, and PERSEVERE) that are set to further transform PE care. --- Resources Management of Massive and Submassive Pulmonary Embolism, Iliofemoral Deep Vein Thrombosis, and Chronic Thromboembolic Pulmonary Hypertension: A Scientific Statement From the American Heart Associationhttps://pubmed.ncbi.nlm.nih.gov/21422387/ Surgical Management and Mechanical Circulatory Support in High-Risk Pulmonary Embolisms: Historical Context, Current Status, and Future Directions: A Scientific Statement From the American Heart Associationhttps://pubmed.ncbi.nlm.nih.gov/36688837/ Interventional Therapies for Acute Pulmonary Embolism: Current Status and Principles for the Development of Novel Evidence: A Scientific Statement From the American Heart Associationhttps://pubmed.ncbi.nlm.nih.gov/31585051/ Ultrasound-Facilitated, Catheter-Directed Fibrinolysis for Acute Pulmonary Embolismhttps://pubmed.ncbi.nlm.nih.gov/41910345/ PEERLESS II: A Randomized Controlled Trial of Large-Bore Thrombectomy Versus Anticoagulation in Intermediate-Risk Pulmonary Embolismhttps://pubmed.ncbi.nlm.nih.gov/39132600/ Rationale and design of the PE-TRACT trial: A multicenter randomized trial to evaluate catheter-directed therapy for the treatment of intermediate-risk pulmonary embolismhttps://pubmed.ncbi.nlm.nih.gov/39638275/ Reduced-Dose Intravenous Thrombolysis for Acute Intermediate–High-risk Pulmonary Embolism: Rationale and Design of the Pulmonary Embolism International THrOmbolysis (PEITHO)-3 trialhttps://pubmed.ncbi.nlm.nih.gov/34560806/ Design and rationale of the PERSEVERE study: a randomized controlled trial of large-bore mechanical thrombectomy versus the standard of care for high-risk pulmonary embolism https://pubmed.ncbi.nlm.nih.gov/41453591/ Design and rationale of PRAGUE-26: a multicentre, randomised trial of catheter-directed thrombolysis for intermediate-high risk acute pulmonary embolismhttps://pubmed.ncbi.nlm.nih.gov/40464677/ --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
Ep. 653 Radiation Lobectomy Techniques & Downstaging for HCC with Dr. Beau Toskich and Dr. Chris Malone
How can targeted liver radiation unlock surgical or transplant options for tough hepatocellular carcinoma (HCC) cases? In this episode of BackTable 2026 HCC Creator Weekend™ host Dr. Kavi Krishnasamy is joined by interventional radiologists Dr. Beau Toskich and Dr. Chris Malone to explore how downstaging and radiation lobectomy with Y-90 are creating new surgical and transplant opportunities for patients with limited future liver remnants. They discuss Y-90’s role as a “test of time” for tumor biology, strategies to prevent post-hepatectomy liver failure, and the ongoing challenge of recurrence even after R0 resection in cirrhotic livers. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by an educational grant from Sirtex and Boston Scientific. --- Timestamps 00:00 - Introduction01:31 - Rad Lobectomy Goals and Case Discussion06:09 - Selective vs Lobar Dosing07:51 - PVE Versus Y9009:35 - Downstaging to Transplant13:03 - Patient Selection Factors19:22 - Radseg vs. Lobar Strategy22:12 - Percent Liver Treated Debate26:38 - Particle Density and Catheter Bias28:04 - Downstaging Evidence MERIT LT36:20 - Operating After Y9041:25 - Hypertrophy Timing and Readiness43:03 - Wrap Up --- More about this episode The discussion features a case of massive right-lobe HCC in a non-cirrhotic patient, with stepwise Y-90 dosing and selective retreatment leading to complete response and marked liver hypertrophy. The doctors compare radiation lobectomy with portal vein embolization (PVE), explore dosimetry advances from studies like DOSISPHERE and MERITS-LT, and stress the importance of careful mapping and patient selection. Additional topics include the pros and cons of different downstaging methods, functional imaging to assess risk, the impact of lab values and portal hypertension, and the practicalities of timing surgery after Y-90. --- Resources Long-Term Overall Survival After Selective Internal Radiation Therapy for Locally Advanced Hepatocellular Carcinomas: Updated Analysis of DOSISPHERE-01 Trialhttps://jnm.snmjournals.org/content/early/2024/01/10/jnumed.123.266211 Downstaging hepatocellular carcinoma before liver transplantation: A multicenter analysis of the "all-comers" protocol in the Multicenter Evaluation of Reduction in Tumor Size before Liver Transplantation (MERITS-LT) consortiumhttps://pubmed.ncbi.nlm.nih.gov/37532179/ --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
Ep. 652 Central Venous Recanalization: Techniques & Challenges with Dr. Gian Paolo Zamboni
When hemodialysis-dependent patients exhaust all conventional venous access options, how do IRs navigate complex central occlusions to provide a lifeline? In this episode of the BackTable Podcast, Dr. Gian Paolo Zamboni of Clínica Alemana in Santiago, Chile joins guest host Dr. Neil Jain to discuss workup protocols and advanced technical algorithms for complex central venous recanalization cases. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by RADPAD® Radiation Protectionhttps://www.radpad.com/ --- Timestamps 00:00 - Introduction03:06 - IR Practice and Referrals in Santiago07:19 - Pre-Procedure Workup15:06 - Standard Recanalization Techniques20:14 - Dual-Access Sharp Recanalization24:43 - Needle Maneuvers and Alternatives29:32 - Predilation, IVUS, and Stent Sizing37:42 - Transhepatic Technique and Indications45:45 - Tract Closure, Anticoagulation, and Follow-up50:03 - Advice and Closing Remarks --- More about this episode The physicians review the critical role of pre-procedural planning, emphasizing the necessity of thorough workup with CT venography to accurately assess remaining vascular capital. Dr. Zamboni shares how his group addresses severe central venous occlusions, outlining a structured, stepwise approach that begins with standard maneuvers and progresses to sharp recanalization techniques before opting for dual-access approaches. He outlines critical safety measures, highlighting the importance of performing intraprocedural cardiac ultrasound, pre-dilating with caution, and keeping covered stents on the shelf to prevent fatal cardiac tamponade. For patients who lack viable conventional iliofemoral and IVC access, Dr. Zamboni shares an advanced jugular-to-transhepatic strategy, walking through the steps and nuances of creating a reliable working route, optimizing inflow, and managing post-procedure anticoagulation. Finally, Dr. Zamboni offers invaluable advice for IRs on mastering foundational techniques before tackling advanced cases and building strong, collaborative relationships with referring providers. --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
Ep. 651 Radioembolization Workflow: Insights & Best Practices with Dr. Nima Kokabi and Dr. Kirema Garcia-Reyes
What does it really take to run a high-volume Y-90 program that is efficient, scalable, and patient-centered? In this episode of BackTable 2026 HCC Creator Weekend™, host Dr. Zach Berman is joined by Drs. Nima Kokabi and Kirema Garcia-Reyes to break down the systems, workflows, and strategies that drive successful radioembolization centers. The conversation focuses on overcoming referral and insurance delays, implementing multidisciplinary clinics, and using tools like single-session Y-90 and routine post-treatment dosimetry to reduce treatment times and improve outcomes. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by an educational grant from Sirtex and Boston Scientific. --- Timestamps 00:00 - Introduction04:46 - Multidisciplinary Model on Radioembolization08:39 - Referral Pathways and Embolization Preferences13:18 - Y-90 Follow Up and Imaging15:51 - Procedure Preparation and Involvement18:00 - Dosimetry Planning and Software ROI22:59 - Analyzing Outcomes and Quality Control26:47 - Various Ways to Expedite Treatments34:04 - Wrap Up and Credits --- More about this episode The doctors discuss the importance of robust internal systems for patient selection, integration of dosimetry planning, and standardized follow-up protocols.They share insights on procedural workflows, including best practices for dosimetry ownership and equipment setup, and highlight the growing role of post-Y-90 dosimetry as both a quality control measure and a billable service. The episode also explores the order-map-treat paradigm, the impact of multidisciplinary tumor boards and clinics, and how single-session strategies are reshaping HCC care by cutting delays, reducing costs, and enhancing the patient experience. --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
Ep. 650 IVC Filters: Indications, Techniques, & Best Practices with Dr. Daniel O'Neal
Routine doesn’t mean risk-free. What should be considered before, during, and after inferior vena cava (IVC) filter placement? In this episode of the BackTable Podcast, interventional radiologist Dr. Daniel O’Neal (Ohio State University) joins guest host Dr. Jessica Yoon to walk through the workup protocols, technical considerations, and multidisciplinary approaches required for placing and following up on IVC filters. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by RADPAD® Radiation Protectionhttps://www.radpad.com/ --- Timestamps 00:00 - Introduction02:10 - IVC Filter Basics07:37 - Workup and Contraindications12:18 - Pre-Procedural Imaging and Timing14:35 - Procedural Technique18:53 - Cavagram and Variant Anatomy23:18 - Filter Positioning and Deployment30:02 - IVC Filter Complications33:58 - Post-Placement Follow-Up39:14 - Final Thoughts and Closing Remarks --- More about this episode The physicians review the key indications for the procedure, highlighting evidence-based patient selection and emphasizing the need for interventional radiologists to critically assess the clinical workup rather than function merely as technicians. They discuss how a comprehensive pre-procedural workup relies on cross-sectional imaging to identify access obstacles and to plan for adequate filter placement in cases of variant anatomy. Dr. O’Neal also shares technical tips from the suite, including deployment mechanics, positioning considerations, and strategies for preventing common complications. The conversation concludes with the IR’s ongoing responsibility to ensure a robust, multidisciplinary follow-up system with referring specialties, outlining potential strategies to ensure these devices are safely retrieved in a timely manner when no longer indicated. --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
Ep. 649 Y90 Radioembolization Dosimetry: Techniques & Challenges with Dr. Nima Kokabi and Dr. Riad Salem
Can the right dosimetry approach turn palliative Y90 into a curative therapy? In this episode of the BackTable 2026 HCC Creator Weekend™, Interventional oncologists Dr. Riad Salem, Dr. Nima Kokabi, and Dr. Zach Berman examine modern Y90 dosimetry, from the decline of body-surface-area calculations to newer strategies that tailor treatment intensity to tumor burden, liver reserve, and clinical intent. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by an educational grant from Sirtex and Boston Scientific. --- Timestamps 00:00 - Introduction03:16 - MIRD and Dosing Considerations06:20 - BSA Is Dead09:26 - Early Stage Segmentectomy13:04 - Sphere Density Questions18:12 - CPN as the Goal18:41 - BCLC B Multifocal Strategy22:56 - Radiation Lobectomy Explained25:49 - Surgery and Adhesions28:59 - Advanced PVT Patients30:22 - Dosisphere and Biomarkers34:29 - Wrap Up --- More about this episode The doctors discuss how to choose how much radiation treatment to give and why “activity” (what you order) is different from “dose” (what tissue receives). The episode goes on to compare one-area calculations with more nuanced methods that distinguish tumor from healthy tissue, and explains why advanced 3D planning is often simpler after treatment than before. The discussion also covers treatment goals for various clinical scenarios, such as when to aim for complete ablation versus palliation, managing radiation lobectomy, and tailoring therapy in cases with portal vein tumor thrombus. The episode concludes with insights on how imaging informs treatment intensity and how local and systemic therapies work together in the latest Y90 approaches. --- Resources Combination treatment with transarterial chemoembolization, radiotherapy, and hyperthermia (CERT) for hepatocellular carcinoma with portal vein tumor thrombosis: Final results of a prospective phase II trialhttps://pmc.ncbi.nlm.nih.gov/articles/PMC5581058/ A global evaluation of advanced dosimetry in transarterial radioembolization of hepatocellular carcinoma with Yttrium-90: the TARGET studyhttps://pubmed.ncbi.nlm.nih.gov/35394152/ Y90 Radioembolization Significantly Prolongs Time to Progression Compared With Chemoembolization in Patients With Hepatocellular Carcinomahttps://pubmed.ncbi.nlm.nih.gov/27575820/ Long-Term Overall Survival After Selective Internal Radiation Therapy for Locally Advanced Hepatocellular Carcinomas: Updated Analysis of DOSISPHERE-01 Trialhttps://jnm.snmjournals.org/content/early/2024/01/10/jnumed.123.266211 --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
